Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Vermont for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Vermont only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Vermont (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Washington County Family Center (NPI 1316035660)

Field	Value
Entity Type	Organization
Organization	Washington County Family Center
Address	383 Sherwood Dr
City	Montpelier
State	VT
ZIP	05602
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	October 11, 2006

Payer Source	Total Paid
Medicaid	$6.7M
Medicare	$0

Key Findings

WASHINGTON COUNTY FAMILY CENTER is effectively a single-payer Medicaid provider: there is no Medicare billing on file while total Medicaid revenue is $6.7M, indicating the organization’s operations and revenue are concentrated entirely within the Medicaid program rather than split across Medicare and Medicaid. This single-payer footprint suggests services are targeted to populations and benefit structures covered by Medicaid rather than Medicare fee-for-service lines.

Revenue concentration is highly focused: the top three Medicaid codes account for 98.9% of the provider's Medicaid revenue, with T1024 alone representing $5.9M or 88.4% of Medicaid revenue. This concentration implies the organization's financial viability and service volume are tightly linked to reimbursement and utilization patterns for a very small set of service types.

The dominant code T1024 (Evaluation and treatment by an integrated, specialty team), with 10.1K claims and $587 average paid/claim, positions the provider as a large regional deliverer of coordinated specialty care for severely handicapped children or similar populations. The code’s weight in revenue indicates the center operates as a multidisciplinary, team-based program delivering recurring encounter-level services rather than episodic acute care.

Competitive standing for T1024 is solid but not exclusive: the provider ranks #3 of 14 in-state and sits at the 85th percentile, which frames it as a meaningful mid-to-upper-tier provider of this service in Vermont. The descriptor “typical, unremarkable volume for this code” alongside the high absolute revenue suggests the state market has several comparable organizations and that this center is an important but not dominant player.

T2023 (Targeted case management; per month) is the provider’s second major revenue source with 1.7K claims, $375 average paid/claim and $645.8K in revenue, comprising 9.7% of Medicaid revenue; the provider ranks #1 of 9 in-state and is described as “notably above typical state volume.” This indicates WASHINGTON COUNTY FAMILY CENTER is a leading statewide provider of monthly targeted case management services and likely maintains administrative capacity and client panels that support continuous case management workflows.

The remainder of billed codes each contribute minimal revenue relative to the top two lines: 97530 accounts for $56.1K (0.8% of Medicaid revenue) and other listed codes individually represent 0.6% or less of Medicaid revenue. Several codes (e.g., 97129, 97130, 99199, T1027, T1017) show claims but $0 average paid/claim in the dataset, signaling either non-reimbursed reporting, bundled payment arrangements, or data artifacts rather than meaningful separate revenue streams.

Tenure: the provider’s NPI was enumerated on 2006-10-11 (approximately 20 years ago), indicating long-standing participation in Medicaid and a sustained operational presence in the state market. This longevity supports the pattern of concentrated, programmatic service delivery reflected in the billing mix.

Operational implication: the mix of high-volume T1024 encounters and leading-state volume in T2023 suggests the organization functions primarily as a developmentally disabled services day training and coordinated care agency, with infrastructure oriented to recurring team-based evaluations and ongoing case management rather than a broad array of therapy or procedural services. Payers and analysts should treat contract negotiations, utilization management, and quality monitoring for these specific service lines as most material to the provider’s financial and operational risk profile.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	10,070	$590	$5.9M
T2023	Targeted case management; per month	1,720	$380	$645.8K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	620	$90	$56.1K
97127	N/A	400	$90	$37K
T1016	Case management, each 15 minutes	11,360	$1	$22.7K
H2000	Comprehensive multidisciplinary evaluation	10	$540	$7K
S9445	Patient education, not otherwise classified, non-physician provider, individual, per session	2,050	$1	$4.1K
97129	The provider works directly one–on–one with the patient to help him improve cognitive functions such as thinking, remembering, reasoning, and problem solving and the ability to plan, organize, and…	40	$0	$0
97130	The provider works directly one–on–one with the patient to help him improve cognitive functions such as thinking, remembering, reasoning, and problem solving and the ability to plan, organize, and…	40	$0	$0
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	20	$0	$0

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Vermont providers billing the same CPT/HCPCS codes.

Claims Volume vs. Vermont Distribution

Washington County Family Center — 1 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. Vermont median

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	16	20	6,570	$6,270	$59.7M
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	3	10	7,720	$560	$4.2M
T2023	Targeted case management; per month	1	10	870	$390	$292.1K
T1027	Family training and counseling for child development, per 15 minutes	8	10	2,700	$80	$213.5K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	15	40	370	$90	$133.5K
T1017	Targeted case management, each 15 minutes	10	20	1,580	$30	$102.9K
T1016	Case management, each 15 minutes	13	40	3,900	$1	$31.1K
H2000	Comprehensive multidisciplinary evaluation	19	20	50	$50	$24.3K
97127	N/A	2	10	1,310	$10	$18.5K
T1022	Contracted home health agency services, all services provided under contract, per day	2	10	760	$10	$13.8K

Showing 1–10 of 14

Nearby Providers

Other providers in the same ZIP code as Washington County Family Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Washington County Mental Health Services, Inc.	VT	Community/Behavioral Health Agency	$0	$99.3M
Treatment Associates, Inc	VT	Mental Health Counselor	$0	$6.2M
Central Vermont Medical Center Inc	VT	Family Medicine Physician	$0	$4.1M
Baart Behavioral Health Services, Inc.	VT	Substance Use Disorder Rehabilitation Clinic/Center	$202.1K	$2.8M
Benjamin Newman	VT	Clinical Social Worker	$0	$1.5M
Central Vermont Medical Center Inc	VT	Internal Medicine Physician	$0	$907.7K
Keene Medical Products, LLC	VT	Durable Medical Equipment & Medical Supplies	$0	$678.6K
M Gould	VT	Psychologist	$0	$574.9K
City Of Montpelier Ambulance	VT	Land Ambulance	$190.7K	$378.7K
John Lansky	VT	General Practice Dentistry	$0	$466.9K

Washington County Family Center — Billing Profile & Reimbursement Data

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Washington County Family Center — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References